Login to Access Video or Poster Abstract: MP79-20
Sources of Funding: None

Introduction

Pelvic fractures with associated urethral injuries are associated with a high risk of erectile dysfunction (ED) perhaps due to the proximity of the cavernosal nerve to the bulbomembranous junction. We sought to compare the frequency and severity of new onset ED in pelvic fracture patients with and without urethral injuries and to identify potential risk factors for ED in the setting of pelvic injury.

Methods

A retrospective analysis was conducted evaluating male patients treated for pelvic fractures with and without urethral injury at a level 1 trauma center between 2005 and 2016. The International Index of Erectile Function (IIEF) questionnaire was administered by telephone to assess post-injury ED. Additional questions regarding pre-injury sexual function, glans vascular symptoms, glans sensitivity, and an updated past medical history were also administered. A diagnosis of new onset ED was defined as the patient having no recollection of ED prior to injury and subsequently having an IIEF score of <22 after injury. Glans vascular symptoms were defined as having a cold glans during an erection. Penile sensitivity was described as either decreased or increased sensitivity of the glans penis.

Results

Of the 118 patients, 42% (50/118) patients responded to the questionnaire: 21 (42%) with pelvic fracture urethral injuries (PFUI) and 29 (58%) with pelvic fractures alone. We observed a numerical increase in new-onset ED in the PFUI group (n=12, 57%) when compared to the pelvic fracture alone group (n=11, 38%, p=0.29). The mean post-injury IIEF score was higher for the PFUI group (18 ± 7.6) than the pelvic fracture alone group (13 ± 8.7, p=0.05), with the PFUI patients more frequently developing severe ED (IIEF <7) (p<0.05). There were no significant differences in glans vascular symptoms (p=0.33) or penile sensitivity (p=0.17) between the two groups. Age, comorbidities, concomitant injuries, pelvic fracture pattern, and need for pelvic angioembolization were not risk factors for developing ED in either cohort.

Conclusions

ED was more severe in patients with PFUI compared to patients with pelvic fractures alone. Based on our results, a larger prospective analysis is warranted to better characterize ED in pelvic fracture patients.

Funding

None